Healthcare Provider Details

I. General information

NPI: 1841232352
Provider Name (Legal Business Name): IHC HEALTH SERVICES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/11/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

975 CHAMBERS ST
SOUTH OGDEN UT
84403-4591
US

IV. Provider business mailing address

975 CHAMBERS ST
SOUTH OGDEN UT
84403-4591
US

V. Phone/Fax

Practice location:
  • Phone: 801-387-6200
  • Fax: 801-387-6234
Mailing address:
  • Phone: 801-387-6200
  • Fax: 801-387-6234

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: PAUL T VAN WAGENEN
Title or Position: DIRECTOR OF OPERATIONS
Credential:
Phone: 801-387-3470